organ donation

From Natalia:
"My question is about organ donation. The way it currently stands, a person needs to actively select to be marked as an organ donor when they register. Also, there is a pretty big shortage of organs in the meantime. Certain other countries have made it mandatory to choose a preference: either you are explicitly marked as an organ donor or you are explicitly marked as not an organ donor. This kind of mandated choice has its positive aspects in that Sweden, Brazil have both seen a big increase in people willing to be organ donors. Then, there is the possibility of “presumed consent” (unless family objects) which Finland, Greece, Italy, Norway and Belgium use…Belgium passed a version of presumed consent in 1986 and has effectively done away with an organ-transplant waiting list because only 2% of the population opts out. My question for you is: do you think either of these methods would be a good way of addressing this issue in the US? If so, at the federal or state level? If not, why not?"

The one big issue I see with organ donation programs is the potential for people who do not believe in organ donation because of their religion to accidentally donate organs. This is offset, of course, by the crushing waiting list for organs in this country.

Presumed consent will almost certainly include people who do not want to be included. Inevitably, rushed DMV clerks will not explain the organ donation procedures properly, or will forget, and people for whom it is important to opt out will not do so. If the goal is to maximize organ donations without infringing upon individuals' rights not to donate organs, a presumed consent system is probably not good, for the same reason that the current system of presumed nonconsent is bad - presuming ANYTHING means that a group of people will not indicate their preference even when they have one.

However, a mandatory selection process seems to make a lot of sense to me. Lots of people don't check the box because the default is to not check the box, or because they don't want to read the instructions for an optional checkbox. Forcing someone to select either way could substantially improve organ donation rates. It's not a surprise that it's worked in Sweden and Brazil, and I don't see a reason it wouldn't work here also.